Abstract PO5-11-01: Audit of multidisciplinary team meetings for improving breast cancer care

Abstract

Abstract Introduction: Multidisciplinary team (MDT) meeting is a well-established method of optimising care for breast cancer patients. However, its effectiveness has not been proven yet. The present study aims to audit the functioning of MDT at a tertiary care hospital in a low-middle income country. Methods: This study examines the prospectively maintained database of patients being discussed in MDT meetings occurring from August 2018 till June 2023. The MDT was suspended for few months in between owing to the COVID pandemic. The analysis was done in terms of indications of discussion, referring department, modification in the pre-MDT plan, new investigation advised, radiological and pathological concordance, significant change in management strategy and interesting cases. The analysis is both qualitative and quantitative. Quantitative analysis involves percentages, mean and median. Results: MDT at our institute was conducted every Saturday at 12 noon as an in-person meeting. The MDT was suspended from May 2020 till June 2021 in view of the pandemic. It was restarted in July 2021, on an online platform and is continued as such. A total of 473 cases were discussed with 181 (38.2%) benign causes and rest were malignant. The most common indication of discussion for malignant cases was feasibility of breast conservation (59.9%) followed by ruling out recurrence/residual disease (17.4%). The indication for benign cases was rad-path concordance and ruling out phyllodes in a case of fibroepithelial lesion. In 31.4% of the cases the plan was modified from the pre-MDT plan and there was improved care. 34.7% cases were advised to get a new investigation done in form of contrast enhanced mammogram or MRI. Seventy nine percent cases were feasible for BCS, and it was done involving few complex surgeries as well. The most common indication for deferring BCS was extensive DCIS. The total number of man hours spent in preparation as well as MDT were analysed with improved clinical care and revealed the MDT to be a time intensive exercise with poor efficacy in terms of hours spent per patient. The time to decision making was increased at an average of 7.5 days for these patients. Conclusion: MDT helps to achieve goals of superior clinical care for both benign and malignant breast disorders at the cost of increased time to decision. It is labour intensive with capability of changing decision in one third of the cases. However, MDT needs regular audit to ensure optimum care with available resources. Citation Format: Kanika Sharma, Gopal Puri. Audit of multidisciplinary team meetings for improving breast cancer care [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-11-01.